Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content +++ SURFACE EPITHELIAL TUMORS +++ Seborrheic Keratosis ++ Appearance: sharply delineated, scaly or greasy, tan papules that appear “stuck on” the surface (Fig. 11-1) Location: upper trunk, shoulder, face, and scalp (sun-exposed areas), but can occur anywhere (except palms and soles) Demographics: more than 30 years Histology: epithelial proliferations characterized by hyperkeratosis, papillomatosis, and acanthosis, with horn pseudocysts (called “pseudo” because they connect to surface, and they have no true epithelial lining) Leser-Trelat syndrome: sudden onset of numerous seborrheic keratoses associated with internal malignancies, most commonly GI adenocarcinoma, breast carcinoma, and lymphoma Variations Inverted follicular keratosis: verrucous, intradermal or “inverted” form of irritated seborrheic keratosis along a hair follicle, with prominent squamous eddies Dermatosis papulosa nigra: multiple small, pedunculated, and heavily pigmented tag-like papules on the face of African-American and Afro-Caribbean patients (Fig. 11-2) Stucco keratosis (keratosis alba): white-to-light brown, flat keratotic papule on dorsa of feet, ankles, hands, and forearms Melanoacanthoma: deeply pigmented seborrheic keratosis in which an epidermal proliferation of large dendritic melanocytes is identified Acanthosis nigricans: hyperpigmented velvety plaques on neck and axillae associated with obesity, diabetes, and endocrinopathies; histology similar to seborrheic keratosis but no acanthosis Confluent and reticulated papillomatosis (CARP): multiple brown verrucous papules in reticulated pattern on inframammary or interscapular trunk during puberty; histology similar to seborrheic keratosis but no acanthosis and pityrosporum can be identified Lichenoid keratosis: solitary pink to red-brown papule on forearm or upper chest; may represent inflamed lentigo, actinic keratosis, or seborrheic keratosis ++ FIGURE 11-1 Seborrheic keratosis. (Used with permission from Dr. Asra Ali.) Graphic Jump LocationView Full Size||Download Slide (.ppt) ++ FIGURE 11-2 Dermatosis papulosa nigra. (Used with permission from Dr. Asra Ali.) Graphic Jump LocationView Full Size||Download Slide (.ppt) +++ Epidermal Nevus ++ Appearance: yellowish-brown warty papules or plaques (Fig. 11-3) Location: usually trunk and extremities Demographics: birth or during childhood Characterization: congenital hamartoma (nevus) of epidermis Three subtypes Nevus verrucosus: solitary or multiple localized lesions Nevus unius lateralis: extensive unilateral linear distribution Ichthyosis hystrix: extreme involvement with bilateral or generalized distribution Histology: hyperkeratosis, papillomatosis, acanthosis, and elongation of the rete ridges Syndromes Epidermal nevus syndrome: skeletal, ocular, and central nervous system (CNS) abnormalities Nevus comedonicus syndrome: nevus comedonicus with cutaneous, skeletal, and CNS abnormalities Variations Nevus sebaceus: see Sebaceous Tumors Linear porokeratosis: see Porokeratosis Linear epidermal nevus: verrucous yellow-brown papules in a linear arrangement (systemic form follows Blaschko lines) due to heterozygous point mutation in the keratin 10 gene; histologically resembles nevus sebaceus with focal epidermolytic hyperkeratosis and lack of adnexal components Nevus comedonicus: group of open comedones on face, trunk, neck, and upper extremities; keratin-filled invaginations of the epidermis ++ FIGURE 11-3 Epidermal nevus. (Used with permission from Dr. Asra Ali.) Graphic Jump LocationView Full Size||Download Slide (.ppt) +... Your Access profile is currently affiliated with '[InstitutionA]' and is in the process of switching affiliations to '[InstitutionB]'. Please click ‘Continue’ to continue the affiliation switch, otherwise click ‘Cancel’ to cancel signing in. Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Password? Forgot Username? Sign in via OpenAthens Sign in via Shibboleth